Cosmetic surgery review and Health Ministers’ crackdown explained

The 2022 independent review and Health Ministers’ statement set up the cosmetic surgery advertising crackdown. Here is what they said and what followed.

2 September 202213 min read

On 1 September 2022 the independent review of the regulation of medical practitioners who perform cosmetic surgery published its findings. The next day, 2 September 2022, federal, state and territory Health Ministers met and agreed to “take urgent action” on cosmetic surgery. Together, those two days set the direction for the biggest shake-up of cosmetic surgery regulation and advertising in Australia in years.

If you run a cosmetic clinic or a surgical practice, or you market any doctor who performs cosmetic procedures, these announcements matter because they put advertising squarely in the regulator’s sights. The review called for stronger advertising guidelines and stronger enforcement, including on social media. Ministers backed a crackdown on misleading advertising, including testimonials, and agreed to protect the title “surgeon” in law.

What happened next: these were announcements and recommendations, not binding rules on the day. They were later put into effect. New Medical Board guidelines for doctors who perform cosmetic surgery and procedures, and new guidelines for doctors who advertise cosmetic surgery, took effect on 1 July 2023. A registration standard for an area of practice endorsement for cosmetic surgery also took effect on 1 July 2023. “Surgeon” became a protected title for medical practitioners from 20 September 2023 in most states and territories. Guidelines for non-surgical cosmetic procedures across the other professions followed on 2 September 2025. We cover each of those in separate articles.

What changed

The independent review: 1 September 2022

Ahpra and the Medical Board of Australia commissioned the review in November 2021, after media reports raised concerns about the conduct of some practitioners. The Independent Reviewer was Mr Andrew Brown, a former Queensland Health Ombudsman, supported by an expert panel of Conjoint Professor Anne Duggan, Mr Alan Kirkland and Ms Richelle McCausland. The review began in mid-January 2022 and held six weeks of public consultation, from 4 March to 14 April 2022, which drew 249 written submissions and 595 survey responses. The report was submitted in August 2022 and released on 1 September 2022.

The review’s key findings, as reported by the Medical Board, were that:

there were no universal minimum education or training standards for cosmetic surgery, so any medical practitioner could perform invasive cosmetic procedures
the industry sat largely outside the safeguards of the broader health system
consumers found it hard to identify qualified practitioners in a market saturated with advertising
patient safety issues were significantly under-reported.

It made 16 recommendations for Ahpra and the Medical Board to act on within the existing National Law. The ones most relevant to marketing were:

Advertising and social media: strengthen the advertising guidelines and take stronger enforcement action against practitioners who breach advertising rules, including on social media.
Endorsement: create an area of practice endorsement for cosmetic surgery that sets minimum qualifications, based on programs approved by the Medical Board and accredited by the Australian Medical Council.
Practice guidelines: set clearer expectations for pre-operative screening, informed consent and post-operative care.
Notifications: improve how cosmetic surgery complaints are handled, and run education to address under-reporting.

The Health Ministers’ statement: 2 September 2022

The Health Ministers Meeting statement of 2 September 2022 recorded agreement to take urgent action, including to:

protect the title “surgeon” through legislative amendment, so that doctors using the title have the requisite training
ask the Australian Commission on Safety and Quality in Health Care (ACSQHC) to lead a review of licensing standards for private hospitals, day procedure centres and clinics where cosmetic procedures are performed, and to develop national standards for safe, high-quality cosmetic procedures
endorse the Medical Board’s decision to implement all of the review’s recommendations, including an area of practice endorsement, a crackdown on misleading advertising “including the use of testimonials and social media”, stronger guidance and education for doctors, and a national team of regulatory experts to address existing complaints
ask the Health Chief Executives Forum to commission a national public education campaign
withdraw clauses about patient testimonials from the bill then before the Queensland Parliament to amend the Health Practitioner Regulation National Law.

Ministers said they expected urgent action, and asked the Medical Board and the ACSQHC to report back on progress at the November 2022 Health Ministers Meeting.

The testimonial clauses

That last point is easy to overlook, but it affected every health advertiser, not only cosmetic clinics. A National Law amendment bill before the Queensland Parliament had included a proposal to relax the ban on testimonials in advertising regulated health services. Ministers asked for those clauses to be withdrawn, saying the issue of testimonials would be reviewed so that any change was consistent with the cosmetic surgery protections. Ahpra later confirmed that the change was withdrawn from the bill and the existing ban remains in place. The amended National Law that received assent on 21 October 2022 kept the testimonial ban and increased the maximum penalties for advertising offences.

Who it applies to

The review and the Ministers’ statement were aimed at medical practitioners who perform cosmetic surgery, and the clinics and businesses around them. In practice, the people who needed to pay attention were:

doctors performing cosmetic surgery, especially those without specialist surgical registration
doctors and other practitioners performing non-surgical cosmetic procedures, since the advertising crackdown and the later guidelines extended to that sector
cosmetic clinics, day surgeries and their owners, including owners who are not registered practitioners
marketing agencies, content creators and influencers who produce advertising for those practitioners
every advertiser of a regulated health service, because the decision on testimonials affected all professions.

What the announcements signalled

None of the measures were law on 2 September 2022. But they told practices clearly what was coming, and the later rules followed this outline closely.

Stronger advertising guidelines and enforcement

The review recommended strengthening the advertising guidelines and taking stronger enforcement action, including on social media. When the Medical Board’s cosmetic surgery advertising guidelines took effect on 1 July 2023, they banned testimonials in cosmetic surgery advertising (including liking or reposting patient praise), set strict rules for before-and-after images, required social media advertising to be identified as adult content, and banned trivialising and sexualised content. Ahpra also reported that it had been auditing cosmetic surgery advertising proactively since September 2022.

A protected title

Ministers agreed to protect “surgeon” through legislation. That happened through the Health Practitioner Regulation National Law (Surgeons) Amendment Act 2023, with the restriction starting on 20 September 2023 in most states and territories. Only doctors with specialist registration in surgery, obstetrics and gynaecology or ophthalmology can now use the title, alone or in combinations such as “cosmetic surgeon”.

An endorsement for cosmetic surgery

The review recommended an area of practice endorsement setting minimum qualifications. The registration standard took effect on 1 July 2023. Importantly for marketing, the Medical Board’s endorsement page states: “There are no approved programs of study yet.” So no doctor can yet advertise that they hold this endorsement. Check the Board’s list of approved programs and the public register before relying on any later change.

Clearer practice expectations

The review asked for clearer expectations on screening, consent and aftercare. The 2023 practice guidelines brought in GP referral, two pre-operative consultations, a cooling-off period and restrictions on financing and on free or discounted procedures for promotion, including for influencers. Several of those rules shape how cosmetic practices can design booking funnels and promotions.

Facility standards

Ministers asked the ACSQHC to review licensing of the facilities where cosmetic procedures are done and to develop national standards. The 2023 practice guidelines later required cosmetic surgery to be performed in accredited facilities.

What it means for your marketing

From September 2022, the safest assumption was that cosmetic advertising would be scrutinised far more closely, and that anything already non-compliant under the existing general advertising guidelines would be a target. Here is how that played out by channel.

Website

Your website is usually the first place regulators and patients look. After these announcements, practices needed to review:

practitioner titles and bios, particularly any use of “cosmetic surgeon”, “surgeon” or implied specialist status for a doctor without specialist registration
before-and-after galleries, especially images that were edited, inconsistent in lighting or pose, or not of the practitioner’s own patients
wording that minimises risk or recovery, and language that sells an idealised body
any patient stories, quotes or embedded review widgets, which are testimonials.

Google Business Profile and reviews

Because the testimonial ban was kept, nothing changed in principle: you still could not use testimonials in your advertising. Ahpra’s testimonial guidance says patients can still post reviews, but advertisers must not use clinical reviews to promote their services, and responsibility follows control of the content. The later cosmetic surgery advertising guidelines went further for cosmetic surgery: liking, responding to, reposting or linking to patient praise counts as using a testimonial, so reviews on your Google Business Profile should not be shared or showcased in your marketing. Under the 2023 guidelines, practitioners were also expected to disable reviews, comments or tagging where they control them.

Social media and influencers

Social media was named specifically by the review and by Ministers. That meant a clear focus on:

reels and stories that turned surgery into entertainment, with music, dancing or humour
sexualised imagery, swimwear or lingerie shots, and emojis over body parts
influencer arrangements, including free or discounted surgery in exchange for posts
reposting or liking patient content that praised a doctor or result.

The later guidelines made the practitioner responsible for influencer and ambassador content they engage, and banned free or discounted procedures for promotion.

Paid ads

Paid social and search ads face the same rules as organic content. Plan for any cosmetic surgery ad to be identified as adult content, to avoid targeting under-18s and vulnerable groups, and to avoid discounts, gifts or time-limited offers tied to surgery. Those were all features of the July 2023 advertising guidelines.

Email and SMS

Promotional emails and SMS to past or prospective patients are advertising too. Recall campaigns, “last chance” offers and bundled package promotions all needed reviewing against the coming rules on inducements and finance.

Printed and in-clinic material

Brochures, letterheads, business cards and clinic windows all carry titles. When the surgeon title was later protected, the Medical Board specifically said references to “surgeon” must be removed from places such as websites, social media, letterheads, business cards and clinic windows.

Common mistakes we see

These are general patterns rather than any particular practice.

Treating announcements as optional. The review findings and Ministers’ statement were not binding rules, but the existing National Law advertising provisions already applied. Much of what the review criticised, such as testimonials and misleading images, was already prohibited.
Assuming “cosmetic surgeon” was safe because it was common. Ministers flagged the title on 2 September 2022, and it became a criminal offence to misuse it for doctors without the right specialist registration from 20 September 2023.
Waiting for the final guidelines before cleaning up social media. Ahpra was already auditing cosmetic surgery advertising from September 2022.
Thinking testimonials would soon be allowed. Ministers asked for the testimonial clauses to be withdrawn, and the ban stayed.
Forgetting old content. Archived blog posts, old reels, pinned stories and historic posts are still advertising if they remain public.
Leaving influencer contracts unreviewed. Promotional arrangements made in good faith years earlier can conflict with later rules on free or discounted procedures and responsibility for third-party content.

A practical checklist

List every place your practice advertises: website, Google Business Profile, Instagram, Facebook, TikTok, YouTube, directories, email, SMS, print and signage.
Check each practitioner’s title against their registration on the Ahpra public register. Flag any use of “surgeon” or “cosmetic surgeon” by a doctor without specialist registration in surgery, obstetrics and gynaecology or ophthalmology.
Remove testimonials, patient quotes, review carousels and reposted patient content.
Audit before-and-after images: genuine patients of that practitioner, no editing or filters, consistent conditions, and clear consent for advertising use.
Remove sexualised, trivialising or entertainment-style content about surgery.
Review any influencer, ambassador or content-creator arrangements, and stop offering free or discounted procedures in exchange for promotion.
Review finance, payment plan and package offers.
Check that risk and recovery information is realistic and easy to find from every procedure page and post.
Set up a sign-off process so a registered practitioner approves advertising before it goes live.
Keep a dated record of the changes you make.

How this fits with other rules

National Law. Section 133 of the Health Practitioner Regulation National Law already prohibited advertising a regulated health service in a way that is false, misleading or deceptive, offers gifts or discounts without stating the terms, uses testimonials, creates an unreasonable expectation of beneficial treatment, or encourages indiscriminate or unnecessary use of services. The cosmetic surgery reforms built on these rules rather than replacing them.

Ahpra’s general advertising guidelines. The Guidelines for advertising a regulated health service, revised from 14 December 2020, applied to all professions and still apply. The later cosmetic surgery advertising guidelines add specific expectations for cosmetic surgery on top.

Penalties. The National Law amendments that received assent on 21 October 2022 raised the maximum penalties for advertising offences. Ahpra states the maximum rose from $5,000 to $60,000 for an individual and from $10,000 to $120,000 for a body corporate.

TGA. If your cosmetic services involve therapeutic goods, the Therapeutic Goods Act and the Therapeutic Goods Advertising Code also apply. Prescription-only medicines, such as those used in many cosmetic injectables, cannot be advertised to the public.

Australian Consumer Law. Misleading or deceptive conduct, including misleading claims about results or prices, can also breach the Australian Consumer Law, which is enforced by the ACCC and state fair trading agencies.

Frequently asked questions

Did the review change the law on 1 September 2022?

No. The review made recommendations to Ahpra and the Medical Board. The binding rules came later, mainly on 1 July 2023 (guidelines and the endorsement registration standard) and 20 September 2023 (the protected “surgeon” title in most states and territories).

Were testimonials going to be allowed again?

A bill before the Queensland Parliament had proposed relaxing the ban. On 2 September 2022 Health Ministers asked for those clauses to be withdrawn, and Ahpra confirmed the ban remains in place.

Does this only affect plastic surgeons?

No. It mostly affected doctors performing cosmetic surgery without specialist surgical registration, who could no longer call themselves surgeons once the title was protected. The advertising crackdown applied to anyone advertising cosmetic surgery, and the later non-surgical guidelines extended similar advertising rules to injectables and other procedures across all professions.

Can a doctor advertise that they are endorsed for cosmetic surgery?

Not at the time of writing this update. The registration standard took effect on 1 July 2023, but the Medical Board’s endorsement page says there are no approved programs of study yet, so no one can hold the endorsement. An endorsement would also not allow a doctor to use the title “cosmetic surgeon”.

Is there somewhere patients can report concerns?

Yes. Ahpra launched a Cosmetic Surgery Hotline on 5 September 2022. By September 2023 Ahpra reported 428 calls and 179 formal complaints or notifications.

Did enforcement actually follow?

Yes. In its one-year update on 5 September 2023, Ahpra reported 14 doctors who had stopped cosmetic surgery or had significant interim restrictions while investigations continued, and 12 doctors with restrictions after investigation. It described an advertising audit where a doctor used misleading claims, testimonial videos and stock images instead of genuine before-and-after photos. When the doctor did not fix the remaining issues, the Medical Board imposed education conditions and restricted the doctor’s advertising.

Need a hand?

If your cosmetic marketing has grown over several years across a website, social channels and directories, a structured review is the quickest way to find what needs to change. Our AHPRA compliance audit checks titles, images, reviews and social content against the current rules, and our work with cosmetic clinics and plastic surgeons builds those checks into everyday marketing.

This article is general guidance based on the published rules, not legal advice. Final responsibility for advertising sits with the registered practitioner, and complex situations may need independent legal advice.